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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Can MRI Of Pelvis Miss Nerve Root Compression?

Can an MRI (no contrast) of the pelvis (sacral, coccyx) miss nerve root compression? I have red flag CES symptoms (except for severe pain), but, nothing is showing up on MRI of lumbar spine and pelvis. One radiologist thought there was a soft tissue mass in or posterior to the rectum, but, rectal surgeon who did flex. sig. procedure says rectum and colon normal, and he was unable to digitally palpate anything in the sacral region (like an anterior sacral meningocele) via rectal exam. He had some other Radiologists look at the MRI films and they reportedly say there is no soft tissue mass----that it s just the colon or redundancy of it. Rectal surgeon said my symptoms aren t telling him it s neurogenic bowel/bladder----that it s higher up ----maybe cervical spine??? Had a brain MRI following worst headache of my life (occipital--diagnosed in ER as tension, go figure) and then about a week after that I get sudden onset trouble peeing, reduced ability to have BMs, saddle anesthesia (and the butt numbness gets way worse after having a BM!!), sexual dysfunction/altered sensation (feels like half of me down there is novacained or something, numbness on bottom of toes/feet with heat no longer being felt as heat--it s felt as prickling/tingling. A MONTH into this they are finally referring me to a Neurologist (I asked for this from the beginning, but, no luck until today when I told my GP that if there seems to be nothing urgent that can be done to figure out what this is, then I want some therapy to get my nerve function back starting ASAP). So frustrated and uncomfortable (it feels like there is something somewhere deep in the left part of the but area that shouldn t be there or something-----it s a feeling of pressure that gets worse the more I am on my feet--sitting helps sometimes, but, lying down is the best relief for that). ??? HELP!! ??? 44 year old female
Fri, 20 Mar 2015
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General & Family Physician 's  Response
Welcome to health care magic.

1. The radiologist has mentioned that there is a mass like thing he has noticed.
2.In surgeon has went through the rectum - and nothing - suggest its not a bowel pathology.
3.In this case its recommended to get a contrast CT / MRI for further evaluation of the pathology.
4.If there is any mass - an FNAC - Fine needle aspiration cytology will help for definitive diagnosis.
5.If there is any mass adjacent to the exiting nerve - then the compression can be missed as you have pointed about it.

Good luck.
Hope i have answered your query,
any thing to ask ? do not hesitate to ask.
http://doctor.healthcaremagic.com/doctors/dr-ganesh/62888
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Can MRI Of Pelvis Miss Nerve Root Compression?

Welcome to health care magic. 1. The radiologist has mentioned that there is a mass like thing he has noticed. 2.In surgeon has went through the rectum - and nothing - suggest its not a bowel pathology. 3.In this case its recommended to get a contrast CT / MRI for further evaluation of the pathology. 4.If there is any mass - an FNAC - Fine needle aspiration cytology will help for definitive diagnosis. 5.If there is any mass adjacent to the exiting nerve - then the compression can be missed as you have pointed about it. Good luck. Hope i have answered your query, any thing to ask ? do not hesitate to ask. http://doctor.healthcaremagic.com/doctors/dr-ganesh/62888